Table 2.
Overview of diseases caused by the protozoans presented in this review; see Reference [1] and text of this review for further references.
| Giardiasis | Amebiasis | Cryptosporidiosis | |
|---|---|---|---|
| Pathogen | Giardia lamblia | Entamoeba histolytica | Cryptosporidium parvum |
| Transmission | Via (Oo)cysts in feces | ||
| Symptoms | |||
| Acute | Persistent diarrhea (>1 w), malabsorption. | Diarrhea, abdominal pain. | Mild-to-acute diarrhea, nausea, abdominal pain, low-grade fever. |
| Chronic | Malabsorption, loose stools, gassiness, cramping, fatigue, liver or pancreatic inflammations. | Fever, sepsis, liver abscesses, skin lesions. | Severe diarrhea, vomiting, malabsorption, volume depletion and wasting, biliary and respiratory involvement in immunodeficient persons. |
| Diagnosis | |||
| Feces Biopsy material |
Microscopy (cysts), coproantigen test, PCR. | Microscopy (trophozoites, cysts), coproantigen test and PCR. | Microscopy, coproantigen test, PCR, enzyme-immunoassays. |
| Serology | Positive in the case of extraintestinal infection. | ||
| Differential Diagnosis | Cryptosporidiosis, IBS, celiac. | IBD, cancer, bacterial infections. | Giardiasis, Rotavirus, Cyclospora cayetanensis, Clostridium difficile. Microsporidia, IBS, celiac. |
| Management | |||
| First line treatment | Metronidazole (500 to 750 mg p.o. t.i.d., 10 d) | Immunocompetent: NTZ (nitazoxanide)100–500 mg p.o. twice daily, 3 d. HIV: Antiretroviral therapy, possibly combined with NTZ or paromomycin/azithromycin. Other immunodeficiencies: NTZ 500 mg twice daily, 14 d. |
|
| Prevention | Personal hygiene, water treatment, appropriate cleaning and storage of vegetables. | ||